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首页> 外文期刊>Resuscitation. >Introduction of a treatment algorithm can improve the early management of emergency patients in the resuscitation room.
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Introduction of a treatment algorithm can improve the early management of emergency patients in the resuscitation room.

机译：引入治疗算法可以改善急救室中急诊患者的早期管理。

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INTRODUCTION: Successful management of emergency patients with multiple trauma in the hospital resuscitation room depends on the immediate diagnosis and rapid treatment of the most life-threatening injuries. In order to reduce the time spent in the resuscitation room, an in-hospital algorithm was developed in an interdisciplinary team approach with respect to local structures. The aim of the study was to analyse whether this algorithm affects the interval between hospital admission and the completion of diagnostic procedures and the start of life-saving interventions. Moreover, in-hospital mortality was investigated before and after the algorithm was introduced. MATERIAL AND METHODS: In this prospective study, all consecutive trauma patients in the resuscitation room were investigated before (group I, 01/04-10/04) and after (group II, 01/05-11/05) introduction of the algorithm. The times between hospital admission and the end of the diagnostic procedures (ultrasound [sono], chest X-ray [CF], and cranial computed tomography [CCT]), and between hospital admission and the start of life-saving interventions were registered and in-hospital mortality analysed. RESULTS: In the study period, 170 patients in group I and 199 patients in group II were investigated. Injury severity score (ISS) were comparable between the two groups. The intervals between admission and completion of diagnostic procedures were significantly lower after the algorithm was introduced (mean+/-S.D.): sono (11 +/- 10 min versus 7 +/- 6 min, p < 0.05), CF (21 +/- 12 min versus 12 +/- 9 min, p < 0.01), and CCT (55 +/- 27 min versus 32 +/- 14 min, p < 0.01). Moreover, the interval to the start of life-saving interventions was significantly shorter (126 +/- 90 min versus 51 +/- 20 min, p < 0.01). After introducing the algorithm, in-hospital mortality was reduced significantly from 33.3% to 16.7% (p < 0.05) in the most severely injured patients (ISS>or=25). CONCLUSION: The introduction of an algorithm for early management of emergency patients significantly reduced the time spent in the resuscitation room. The periods to completion of sono, CF, and CCT, respectively, and the start of life-saving interventions were significantly shorter after introduction of the algorithm. Moreover, introduction of the algorithm reduced mortality in the most severely injured patients. Although further investigations are needed to evaluate the effects of the Heidelberg treatment algorithm in terms of outcome and mortality, the time reduction in the resuscitation room seems to be beneficial.
机译：简介：在医院复苏室成功治疗多发伤的急诊患者，取决于对最致命生命的伤害的即时诊断和快速治疗。为了减少在复苏室中所花费的时间，跨学科团队针对局部结构开发了院内算法。该研究的目的是分析该算法是否影响入院与诊断程序完成以及挽救生命的干预措施之间的间隔。此外，在引入该算法之前和之后，研究了住院死亡率。材料与方法：在这项前瞻性研究中，在引入算法之前（I组，01 / 04-10 / 04）和之后（II组，01 / 05-11 / 05）对复苏室中所有连续的创伤患者进行了调查。 。记录下从入院到诊断程序结束的时间（超声波[超声]，胸部X线[CF]和颅骨计算机断层扫描[CCT]）以及从入院到开始进行救生干预的时间。分析了院内死亡率。结果：在研究期间，对第一组的170例患者和第二组的199例患者进行了调查。两组的损伤严重程度评分（ISS）相当。引入算法后，入院与完成诊断程序之间的时间间隔明显缩短（平均值+/- SD）：声纳（11 +/- 10分钟对7 +/- 6分钟，p <0.05），CF（21 + / -12分钟对12 +/- 9分钟，p <0.01）和CCT（55 +/- 27分钟对32 +/- 14 min，p <0.01）。此外，开始进行救生干预的时间间隔明显缩短（126 +/- 90分钟与51 +/- 20分钟，p <0.01）。引入该算法后，在重伤最严重的患者中（ISS> or = 25），住院死亡率从33.3％显着降低到16.7％（p <0.05）。结论：引入了一种用于急诊病人早期管理的算法，大大减少了在复苏室花费的时间。引入算法后，分别完成sono，CF和CCT的周期以及开始进行救生干预的时间。此外，该算法的引入降低了最严重受伤患者的死亡率。尽管需要进一步研究以评估海德堡治疗算法在结局和死亡率方面的效果，但减少复苏室中的时间似乎是有益的。

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